Monday, November 16, 2009

Seven "best buys" of poverty eradication

Didn't quite notice it. Mostly Economics points attention to Poverty Action Lab's seven "best buys" of rigorously evaluated, cost-effective and practical policy initiatives to reach the United Nations Millennium Development Goals (MDGs). Esther Duflo has a nice presentation here.

1. For as little as 50 cents per child per year, deworming of children through mass school-based programs can cut school absenteeism by a quarter.

2. It costs no more than $2.25 per child per year to provide remedial education to children who lack basic reading skills.

3. Doing away with small user fees on bednets to make them available for free to pregnant women and mothers in health clinics costs less than $5 per net and can increase uptake by 75 percent.

4. Quotas for women in politics costs practically nothing. Yet, it increases women’s political participation and shift spending towards women’s priorities, such as clean water.

5. It costs $4 per girl per year to provide free primary school uniforms that help keep girls in school and reduce teen pregnancies by 9 percent.

6. Smart subsidies to farmers boost technology adoption, farm productivity and income. Time-limited offers to purchase fertilizers in the harvesting season, with free delivery in the planting season, can massively increase uptake and usage of fertilizers.

7. Small incentives - such as a bag of lentils per shot - can be a minor additional price to pay to get children immunized.

Intutively too, there cannot have been any arguement about the efficacy of the aforementioned seven "best buys", and the evaluations only confirm it. These seven program components, if effectively implemented, can go a long way in achieving the MDG objectives. There are though a few uncovered and very important areas, like promoting institutional deliveries, getting children to school (and not merely keeping them there), improving learning and health care outcomes, which can also be added to the list (will think of a few and post later).

However, I am deeply suspicious of neat policy prescriptions that give the appearance of simplicity to complex social challenges. Given the variations in socio-economic contexts, it may be more appropriate to claim these as "good buys" (as against "best buys"), lest they get rammed down into their target population as non-negotiable components of multi-lateral lending programs, often to the exclusion of other even more effective local-specific solutions (or "buys").

Interestingly, from the context of India, except for the smart subsidies, all the remaining six interventions have been initiated (in some form or the other) in atleast some areas. For example, in the Integrated Tribal Development Agency (ITDA) areas of Andhra Pradesh, these programs have been in place for many years now. In fact, de-worming, remedial education (or bridge courses), mosquito nets (free in tribal areas), student uniforms (in the ashram schools and residential hostels), and incentivizing immunization are always among the top priority for any PO of an ITDA.

I distinctly remember having administered all the aformentioned components (except the subsidies) as a Project Officer of ITDAs, though I haven't come across any evaluation of the impact of these initiatives. However, there are serious implementation challenges with even simple things like deworming or provision of uniforms.

Deworming, quotas, and uniforms are relatively easy to implement, in so far as they have minimal administration (or transaction) costs. Mosquito nets and immunization incentives too can be implemented, especially if its coverage in the village (or the target habitation) is universal. All the aforementioned involve a single transaction between the government provider and the recipients.

However, remedial education and smart subsidies pose substantial challenges. Remdial education involves continuous engagement between teachers and students and the outcome depends on the quality of the interaction, monitoring which poses the usual difficulties. Smart subsidies are likely to pose considerable administration challenges, especially given the huge monies involved and the need to target the benefits.

It needs to be borne in mind that while these may "best buys" may achieve specific outcomes defined by the MDGs, they are small steps in the process of achieving the desired overall quality and outcomes in health care, education, women's empowerment, increasing agricultural productivity etc. There are no magic pills or short cuts to achieving them.

Update 1 (6/4/2012)

A Times article writes, "Two economists, Michael Kremer of Harvard University and Edward Miguel of the University of California, Berkeley, found that deworming reduced school absenteeism by 25 percent in a sampling of schools in Kenya and that regular treatment could lead to an additional year of attendance — all for  $3.50 per student, far less than subsidies, meals, free bicycles or other incentives to keep kids in school.

Children who are regularly dewormed earn over 20 percent more as adults and work 12 percent more hours, while those infected are 13 percent less likely to be literate."

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